nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»10.31146/1682-8658-ecg-188-4-144-149nogr-1640Research ArticleОБЗОРREVIEWРепродуктивные изменения у женщин с целиакиейReproductive changes in women with celiac diseasehttps://orcid.org/0000-0002-2726-9996ОрешкоЛ. С.OreshkoL. S.

Орешко Людмила Саварбековна, доктор медицинских наук, профессор кафедры пропедевтики внутренних болезней, гастроэнтерологии и диетологии им. С. М. Рысса

191015, ул. Кирочная д. 41, Санкт- Петербург

Lyudmila S. Oreshko, Associate Professor of Med. Sci., Professor of the Department of Propedeutics of Internal Diseases, Gastroenterology and Dietetics named after S. M. Ryssa

191015, st. Kirochnaya, 41, St. Petersburg

oreshkol@yandex.ruhttps://orcid.org/0000-0001-7606-2556СеменоваЕ. А.SemenovaE. A.

Семенова Елена Анатольевна, кандидат медицинских наук, ассистент кафедры пропедевтики внутренних болезней, гастроэнтерологии и диетологии им. С. М. Рысса

191015, ул. Кирочная д. 41, Санкт- Петербург

Elena A. Semenova, Cand. of Med. Sci., Assistant of the Department of Propedeutics of Internal Diseases, Gastroenterology and Dietetics named after CM. Ryssa

191015, st. Kirochnaya, 41, St. Petersburg

АлиеваГ. Ч.AlievaG. Ch.

Алиева Гюнель Чингизовна, студентка 4 курса

191015, ул. Кирочная д. 41, Санкт- Петербург

Gyunel Ch. Alieva, 4th year student

191015, st. Kirochnaya, 41, St. Petersburg

БасюлО. В.BasyulO. V.

Басюл Октавия Власовна, студентка 5 курса

191015, ул. Кирочная д. 41, Санкт- Петербург

Oktavia V. Basyul, 5th year student

191015, st. Kirochnaya, 41, St. Petersburg

Государственное бюджетное образовательное учреждение высшего профессорского образования «Северо-Западный государственный медицинский университет имени И. И. Мечникова» Министерства здравоохранения Российской ФедерацииРоссияState budgetary educational institution of higher professorial education “North- Western State Medical University named after I. I. Mechnikov“ of the Ministry of Health of the Russian FederationRussian FederationГосударственное бюджетное образовательное учреждение высшего профессорского образования «Северо- Западный государственный медицинский университет имени И. И. Мечникова» Министерства здравоохранения Российской ФедерацииРоссияState budgetary educational institution of higher professorial education “North- Western State Medical University named after I. I. Mechnikov“ of the Ministry of Health of the Russian FederationRussian Federation20212007202104144149Copyright © Орешко Л.С., Семенова Е.А., Алиева Г.Ч., Басюл О.В., 20212021Орешко Л.С., Семенова Е.А., Алиева Г.Ч., Басюл О.В.Oreshko L.S., Semenova E.A., Alieva G.C., Basyul O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nogr.org/jour/article/view/1640

В статье представлен обзор ретроспективных когортных исследованиях изучения фертильности и исходов беременности у женщин с целиакией. В статье изложены результаты собственных наблюдений акушерско- гинекологического анамнеза у 17 женщин с целииакией за период с 2016 года по 2020 год.

Материалы и методы

Материалы и методы. В ретроспективных когортных исследованиях была проанализирована информация, собранная от пациентов. В эти исследования были включены пациентки с целиакией и здоровые женщины репродуктивного возраста.

Результаты

Результаты. Способность антител классов IgA и IgG к тканевой трансглутаминазе нарушать инвазивность трофобласта и дифференцировку эндотелиальных клеток эндометрия лежит в основе неудач ранней плацентации при целиакии. В случае латентного течения целиакии отмечено повышение риска повторных выкидышей и преждевременных родов.

Заключение

Заключение. Учитывая высокий процент неустановленных диагнозов, крайне важно выявление групп риска с целью своевременного лечения и профилактики осложнений.

The article presents a review of retrospective cohort studies of fertility and pregnancy outcomes in women with celiac disease. The article presents the results of our own observations of obstetric and gynecological anamnesis 17 women with celiac disease for the period from 2016 to 2020. Materials and methods. Information collected from patients was analyzed in retrospective cohort studies. Patients with celiac disease and healthy women of reproductive age were included in these studies. Result. The ability of IgA and IgG class antibodies to tissue transglutaminase to disrupt trophoblast invasiveness and endometrial endothelial cell differentiation underlies the failure of early placentation in celiac disease. In the case of the latent course of celiac disease there is an increased risk of recurrent miscarriages and preterm births, impaired growth of the fetus with low birth weight. Conclusion. Given the high percentage of unidentified diagnoses, it is extremely important to identify risk groups for timely treatment and prevention of complications.

целиакияфертильностьбесплодиебеременностьceliac diseasefertilityinfertilitypregnancyReferencesПарфенов А. И. Целиакия: эволюция представлений о распространенности, клинических проявлениях и значимости этиотропной терапии. М: Анахарсис, 2007. – 375 с. – (Очерки современной гастроэнтерологии); ISBN 5–901352–77–7.Parfenov A. I. Celiac disease: evolution of understanding of the prevalence, clinical manifestations and the importance of etiotropic therapy. M: Anacharsis, 2007. 375 p. (Essays on modern gastroenterology); ISBN 5–901352– 77–7. (In Russ.)Орешко Л. С. Исторические и клинические аспекты целиакии: монография. – СПб.: СПбГМА им. И. И. Мечникова, 2010. – 120 с.Oreshko L. S. Historical and clinical aspects of celiac disease: monograph. SPb.: SPbGMA them. I. I. Mechnikova, 2010. 120 p. (In Russ.)Ferguson R, Holmes GK, Cooke WT. Coeliac disease, fertility, and pregnancy. Scand J Gastroenterol. 1982 Jan;17(1):65–8. doi: 10.3109/00365528209181045. PMID: 7134839.Ferguson R, Holmes GK, Cooke WT. Coeliac disease, fertility, and pregnancy. Scand J Gastroenterol. 1982 Jan;17(1):65–8. doi: 10.3109/00365528209181045. PMID: 7134839.Лазебник Л. Б., Ткаченко Е. И., Орешко Л. С., Ситкин С. И., Карпов А. А., Немцов В. И., Осипенко М. Ф., Радченко В. Г., Федоров Е. Д., Медведева О. И., Селиверстов П. В., Соловьева Е. А., Шабанова А. А., Журавлева М. С. Рекомендации по диагностике и лечению целиакии взрослых. Экспериментальная и клиническая гастроэнтерология. 2015;5(117): 3–12.Lazebnik LB, Tkachenko YI, Oreshko LS, et al.; Scientific Society of Gastroentorology of Russia. [Guidelines for diagnosis and treatment of celiac disease]. Eksp Klin Gastroenterol. 2015;(5):3–12. (In Russ.) PMID: 26387169.Khashan AS, Henriksen TB, Mortensen PB, McNamee R, McCarthy FP, Pedersen MG, Kenny LC. Th e impact of maternal celiac disease on birthweight and preterm birth: a Danish population- based cohort study. Hum Reprod. 2010 Feb;25(2):528–34. doi: 10.1093/humrep/dep409. Epub 2009 Nov 24. PMID: 19939833.Khashan AS, Henriksen TB, Mortensen PB, McNamee R, McCarthy FP, Pedersen MG, Kenny LC. Th e impact of maternal celiac disease on birthweight and preterm birth: a Danish population- based cohort study. Hum Reprod. 2010 Feb;25(2):528–34. doi: 10.1093/humrep/dep409. Epub 2009 Nov 24. PMID: 19939833.Tur- Torres MH, Garrido- Gimenez C, Alijotas- Reig J. Genetics of recurrent miscarriage and fetal loss. Best Pract Res Clin Obstet Gynaecol. 2017 Jul;42:11–25. doi: 10.1016/j.bpobgyn.2017.03.007. Epub 2017 Mar 27. PMID: 28412101.Tur- Torres MH, Garrido- Gimenez C, Alijotas- Reig J. Genetics of recurrent miscarriage and fetal loss. Best Pract Res Clin Obstet Gynaecol. 2017 Jul;42:11–25. doi: 10.1016/j.bpobgyn.2017.03.007. Epub 2017 Mar 27. PMID: 28412101.Martinelli P, Troncone R, Paparo F, et al. Coeliac disease and unfavourable outcome of pregnancy. Gut. 2000 Mar;46(3):332–5. doi: 10.1136/gut.46.3.332. PMID: 10673293; PMCID: PMC1727862.Martinelli P, Troncone R, Paparo F, et al. Coeliac disease and unfavourable outcome of pregnancy. Gut. 2000 Mar;46(3):332–5. doi: 10.1136/gut.46.3.332. PMID: 10673293; PMCID: PMC1727862.Anjum N, Baker PN, Robinson NJ, Aplin JD. Maternal celiac disease autoantibodies bind directly to syncytiotrophoblast and inhibit placental tissue transglutaminase activity. Reprod Biol Endocrinol. 2009 Feb 19;7:16. doi: 10.1186/1477–7827–7–16. PMID: 19228395; PMCID: PMC2649929.Anjum N, Baker PN, Robinson NJ, Aplin JD. Maternal celiac disease autoantibodies bind directly to syncytiotrophoblast and inhibit placental tissue transglutaminase activity. Reprod Biol Endocrinol. 2009 Feb 19;7:16. doi: 10.1186/1477–7827–7–16. PMID: 19228395; PMCID: PMC2649929.Polvi A, Arranz E, Fernandez- Arquero M, Collin P, Mäki M, Sanz A, Calvo C, Maluenda C, Westman P, de la Concha EG, Partanen J. HLA-DQ2-negative celiac disease in Finland and Spain. Hum Immunol. 1998;59(3):169–75.Polvi A, Arranz E, Fernandez- Arquero M, Collin P, Mäki M, Sanz A, Calvo C, Maluenda C, Westman P, de la Concha EG, Partanen J. HLA-DQ2-negative celiac disease in Finland and Spain. Hum Immunol. 1998;59(3):169–75.Van de Wal Y., Kooy Y. M., van Veelen P. A. et al. Small intestinal T cells of celiac disease patients recognize a natural pepsin fragment of gliadin. Proc Natl Acad Sci USA 1998;95:10050–10054.Van de Wal Y., Kooy Y. M., van Veelen P. A. et al. Small intestinal T cells of celiac disease patients recognize a natural pepsin fragment of gliadin. Proc Natl Acad Sci USA 1998;95:10050–10054.Garrote JA, Arranz E, Tellería JJ, Castro J, Calvo C, Blanco- Quirós A. TNF alpha and LT alpha gene polymorphisms as additional markers of celiac disease susceptibility in a DQ2-positive population. Immunogenetics. 2002;54(8):551–5. doi: 10.1007/s00251–002–0498–9Garrote JA, Arranz E, Tellería JJ, Castro J, Calvo C, Blanco- Quirós A. TNF alpha and LT alpha gene polymorphisms as additional markers of celiac disease susceptibility in a DQ2-positive population. Immunogenetics. 2002;54(8):551–5. doi: 10.1007/s00251–002–0498–9Bragde H, Jansson U, Fredrikson M, Grodzinsky E, Söderman J. Celiac disease biomarkers identified by transcriptome analysis of small intestinal biopsies. Cell Mol Life Sci. 2018;75(23): 4385–401. doi: 10.1007/s00018–018–2898–5Bragde H, Jansson U, Fredrikson M, Grodzinsky E, Söderman J. Celiac disease biomarkers identified by transcriptome analysis of small intestinal biopsies. Cell Mol Life Sci. 2018;75(23): 4385–401. doi: 10.1007/s00018–018–2898–5Decker E, Engelmann G, Findeisen A, Gerner P, Laass M, Ney D, Posovszky C, Hoy L, Hornef MW. Cesarean delivery is associated with celiac disease but not inflammatory bowel disease in children. Pediatrics. 2010; 125: e1433-e1440.Decker E, Engelmann G, Findeisen A, Gerner P, Laass M, Ney D, Posovszky C, Hoy L, Hornef MW. Cesarean delivery is associated with celiac disease but not inflammatory bowel disease in children. Pediatrics. 2010; 125: e1433-e1440.Ciacci C, Cirillo M, Auriemma G, Di Dato G, Sabbatini F, Mazzacca G. Celiac disease and pregnancy outcome. Am J Gastroenterol. 1996; 91: 718–722.Ciacci C, Cirillo M, Auriemma G, Di Dato G, Sabbatini F, Mazzacca G. Celiac disease and pregnancy outcome. Am J Gastroenterol. 1996; 91: 718–722.Минайчева Л. И., Брагина Е. Ю., Жалсанова И. Ж., Чеснокова Н. А., Марусин А. В. Ассоциация генетических маркеров целиакии с репродуктивными нарушениями. Альманах клинической медицины. 2019; 47 (1): 72–82. doi: 10.18786/2072–0505–2019–47–006.Minaicheva L.I., Bragina E. Yu., Zhalsanova I. Zh., Chesnokova N. A., Marusin A. V. Association of genetic markers of celiac disease with reproductive disorders. Almanac of Clinical Medicine. 2019; 47 (1): 72–82. (In Russ.) doi: 10.18786/2072–0505–2019–47–006Khan S, Mandal RK, Jawed A, Dar SA, Wahid M, Panda AK, Areeshi MY, Ahmed Khan ME, Haque S. TNF-α –308 G>A (rs1800629) polymorphism is associated with celiac disease: A meta-analysis of 11 case-control studies. Sci Rep. 2016;6:32677. doi: 10.1038/srep32677Khan S, Mandal RK, Jawed A, Dar SA, Wahid M, Panda AK, Areeshi MY, Ahmed Khan ME, Haque S. TNF-α –308 G>A (rs1800629) polymorphism is associated with celiac disease: A meta-analysis of 11 case-control studies. Sci Rep. 2016;6:32677. doi: 10.1038/srep32677Liu RX, Wang Y, Wen LH. Relationship between cytokine gene polymorphisms and recurrent spontaneous abortion. Int J Clin Exp Med. 2015;8(6):9786–92Liu RX, Wang Y, Wen LH. Relationship between cytokine gene polymorphisms and recurrent spontaneous abortion. Int J Clin Exp Med. 2015;8(6):9786–92Li S, Wang L, Xing Z, Huang Y, Miao Z. Expression level of TNF-α in decidual tissue and peripheral blood of patients with recurrent spontaneous abortion. Cent Eur J Immunol. 2017;42(2):156–60. doi: 10.5114/ceji.2017.69357Li S, Wang L, Xing Z, Huang Y, Miao Z. Expression level of TNF-α in decidual tissue and peripheral blood of patients with recurrent spontaneous abortion. Cent Eur J Immunol. 2017;42(2):156–60. doi: 10.5114/ceji.2017.69357Hadziselimovic F, Geneto R, Buser M. Celiac disease, pregnancy, small for gestational age: role of extravillous trophoblast. Fetal Pediatr Pathol. 2007; 26: 125–134.Hadziselimovic F, Geneto R, Buser M. Celiac disease, pregnancy, small for gestational age: role of extravillous trophoblast. Fetal Pediatr Pathol. 2007; 26: 125–134.Anjum N, Baker PN, Robinson NJ, Aplin JD. Maternal celiac disease autoantibodies bind directly to syncytiotrophoblast and inhibit placental tissue transglutaminase activity. Reprod Biol Endocrinol. 2009; 7: 16.Anjum N, Baker PN, Robinson NJ, Aplin JD. Maternal celiac disease autoantibodies bind directly to syncytiotrophoblast and inhibit placental tissue transglutaminase activity. Reprod Biol Endocrinol. 2009; 7: 16.Ciacci C, Tortora R, Scudiero O, Di Fiore R, Salvatore F, Castaldo G. Early pregnancy loss in celiac women: The role of genetic markers of thrombophilia. Dig Liver Dis. 2009; 41: 717–720.Ciacci C, Tortora R, Scudiero O, Di Fiore R, Salvatore F, Castaldo G. Early pregnancy loss in celiac women: The role of genetic markers of thrombophilia. Dig Liver Dis. 2009; 41: 717–720.Bougle D, Proust A. Iron and zinc supplementation during pregnancy: interactions and requirements. Contracept Fertil Steril. 1999;27:537–543.Bougle D, Proust A. Iron and zinc supplementation during pregnancy: interactions and requirements. Contracept Fertil Steril. 1999;27:537–543.Hirson C. Coeliac infertility- folic-acid therapy. Lancet. 1970 Feb 21;1(7643):412. doi: 10.1016/s0140–6736(70)91537–0. PMID: 4189708.Hirson C. Coeliac infertility- folic-acid therapy. Lancet. 1970 Feb 21;1(7643):412. doi: 10.1016/s0140–6736(70)91537–0. PMID: 4189708.

The authors declare that there are no conflicts of interest present.